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Employer
1170 South State Street, Ephrata, PA 17522 · EIN 45-0637755 · Aug 1, 2021 to Jul 31, 2022
Plan year 2021
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Schedule A
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $203,612
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Medical | Unitedhealthcare Insurance Company | Joseph C Bevacqua Jr | 512 | $140,681 5.3% of $2,669,387 |
| Life | Colonial Life & Accident Insurance Company | Mary Susanne Merkhofer | 76 | $7,388 14.0% of $52,800 |
| Life | Colonial Life & Accident Insurance Company | Anchor Insurance Inc | 76 | $6,542 12.4% of $52,800 |
| Life | Colonial Life & Accident Insurance Company | Nicole Townsend Vedder | 76 | $2,089 4.0% of $52,800 |
| Life | Colonial Life & Accident Insurance Company | Joey Grubbs Benefits LLC | 76 | $1,936 3.7% of $52,800 |
| Life | Colonial Life & Accident Insurance Company | David B Merkhofer | 76 | $450 0.9% of $52,800 |
| Life | Colonial Life & Accident Insurance Company | Margarita Macias-Charbonier | 76 | $232 0.4% of $52,800 |
| Life | Colonial Life & Accident Insurance Company | Edward Guy Jr | 76 | $165 0.3% of $52,800 |
| Life | Colonial Life & Accident Insurance Company | George Joseph Faeth | 76 | $21 0.0% of $52,800 |
| Life | Colonial Life & Accident Insurance Company | Angel Gabriel Velazquez-Diaz | 76 | $18 0.0% of $52,800 |
| Life | Colonial Life & Accident Insurance Company | Oms Of Northwest Florida Inc | 76 | $12 0.0% of $52,800 |
| Life | Colonial Life & Accident Insurance Company | Stephen Joseph Joyce | 76 | $9 0.0% of $52,800 |
| Life | Colonial Life & Accident Insurance Company | Howard L Weathers | 76 | $3 0.0% of $52,800 |
| Life | Colonial Life & Accident Insurance Company | Frances Puels-Riccardi | 76 | Comp not disclosed Premium $52,800 |
| Life | Colonial Life & Accident Insurance Company | Ashly Elcock | 76 | Comp not disclosed Premium $52,800 |
| Life | Colonial Life & Accident Insurance Company | Benechoice Enrollment Solutions & T | 76 | Comp not disclosed Premium $52,800 |
| Life | Colonial Life & Accident Insurance Company | Gunn Mowery, LLC | 76 | Comp not disclosed Premium $52,800 |
| Life | Colonial Life & Accident Insurance Company | Mary Susanne Merkhofer | 143 | $12,082 7.5% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Anchor Insurance Inc | 143 | $11,309 7.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Nicole Townsend Vedder | 143 | $3,606 2.2% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Joey Grubbs Benefits LLC | 143 | $3,150 1.9% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | David B Merkhofer | 143 | $837 0.5% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Benechoice Enrollment Solutions & T | 143 | $834 0.5% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Gunn Mowery, LLC | 143 | $789 0.5% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Michelle Elaine Hill | 143 | $279 0.2% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | James Barlett LLC | 143 | $216 0.1% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | George J Faeth | 143 | $192 0.1% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Petrina Skiles | 143 | $151 0.1% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Edward Guy Jr | 143 | $142 0.1% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Ashly Elcock | 143 | $115 0.1% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Stephen Joseph Joyce | 143 | $86 0.1% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Harmony Befefits LLC | 143 | $62 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Mark Christopher Motz | 143 | $55 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Zachary Eugene Vickers | 143 | $49 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Tanya Wishard | 143 | $45 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Stevie Kircher | 143 | $39 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Margarita Macias-Charbonier | 143 | $33 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Angel Gabriel Velazquez-Diaz | 143 | $16 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Michael Francis | 143 | $11 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Howard L Weathers | 143 | $6 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Alfred Clifford | 143 | $6 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Oms Of Northwest Florida Inc | 143 | $2 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Frances Puels-Riccardi | 143 | $1 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Jacqueline E Forbes-Clarke | 143 | $1 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Lance A Bradley | 143 | $1 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Soteria Partners LLC | 143 | $1 0.0% of $161,592 |
| Life | Colonial Life & Accident Insurance Company | Esquen Insurance Group Corp | 143 | Comp not disclosed Premium $161,592 |
| Life | Colonial Life & Accident Insurance Company | Lawrence Prichard | 143 | Comp not disclosed Premium $161,592 |
| Life | Colonial Life & Accident Insurance Company | Judith I Vidal | 143 | Comp not disclosed Premium $161,592 |
| Life | Colonial Life & Accident Insurance Company | Mary Susanne Merkhofer | 39 | $3,903 12.7% of $30,661 |
| Life | Colonial Life & Accident Insurance Company | Anchor Insurance Inc | 39 | $3,459 11.3% of $30,661 |
| Life | Colonial Life & Accident Insurance Company | Nicole Townsend Vedder | 39 | $1,087 3.5% of $30,661 |
| Life | Colonial Life & Accident Insurance Company | Joey Grubbs Benefits LLC | 39 | $973 3.2% of $30,661 |
| Life | Colonial Life & Accident Insurance Company | David B Merkhofer | 39 | $229 0.7% of $30,661 |
| Life | Colonial Life & Accident Insurance Company | Michael Francis | 39 | $180 0.6% of $30,661 |
| Life | Colonial Life & Accident Insurance Company | George J Faeth | 39 | $50 0.2% of $30,661 |
| Life | Colonial Life & Accident Insurance Company | Stephen Joseph Joyce | 39 | $22 0.1% of $30,661 |
| Life | Colonial Life & Accident Insurance Company | Zachary Eugene Vickers | 39 | $19 0.1% of $30,661 |
| Life | Colonial Life & Accident Insurance Company | Soteria Partners LLC | 39 | $17 0.1% of $30,661 |
| Life | Colonial Life & Accident Insurance Company | Jacqueline E Forbes-Clarke | 39 | $8 0.0% of $30,661 |
| Life | Colonial Life & Accident Insurance Company | Edward Guy Jr | 39 | $3 0.0% of $30,661 |
Schedule C
Plan-paid amounts to each named party on the filing, with the role they reported. This is not a carrier commission and is not added to Schedule A.
No Schedule C parties in this year.